Breast Cancer Follow-Up and Management After Primary Treatment: American Society of Clinical Oncology Clinical Practice Guideline Update
- Study type
- Clinical guideline
- Study name
- ASCO Breast Cancer Follow-up 2013
- Design
- Clinical practice guideline update based on a systematic review of the literature (MEDLINE and the Cochrane Library, March 2006 to March 2012)
- Sample size
- 14 new studies included: 9 systematic reviews (3 with meta-analyses) and 5 randomised controlled trials
- Source
- JCO · 2013
In plain words
After finishing the first treatment for breast cancer, regular follow-up is recommended, with a talk about your health, an examination by a doctor and mammograms. If you have no symptoms and the examination finds nothing unusual, routine blood tests, scans and tumour marker tests are not needed. If any new symptom appears, be sure to tell your doctor.
Key points
Key guideline recommendations
Regular history, physical examination and mammography are recommended for breast cancer follow-up.
Physical examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter.
For women who have had breast-conserving surgery, the first post-treatment mammogram should be obtained 1 year after the initial mammogram and at least 6 months after completion of radiotherapy. Thereafter, unless otherwise indicated, a yearly mammographic evaluation should be performed.
The use of complete blood counts, chemistry panels, bone scans, chest radiographs, liver ultrasound, pelvic ultrasound, CT scans, FDG-PET scans, MRI and/or tumour markers (CEA, CA 15-3 and CA 27.29) is not recommended for routine follow-up of an asymptomatic patient with no specific findings on clinical examination.
Study population
Patients with breast cancer who have completed primary treatment with curative intent.
Endpoints
To determine whether new evidence published since the 2006 American Society of Clinical Oncology (ASCO) guideline warranted revision of the existing recommendations.
Safety and side effects
This document is a clinical guideline and does not report safety data (treatment adverse events).
Clinical significance and place in guidelines
This update found that the new evidence (14 studies) did not change the recommendations of the 2006 ASCO guideline, and follow-up based on history, examination and mammography was confirmed. The current status of this guideline and its newer versions should be checked.
Limitations
The abstract does not report the level of evidence or strength of the recommendations. The literature search extended only to March 2012 and does not include newer evidence.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.